Early-Onset Atopic Dermatitis Linked to Increased Risk of Pediatric Uveitis

Children diagnosed with early-onset atopic dermatitis (AD) are at a significantly higher risk of developing pediatric uveitis, according to research published in JAMA Ophthalmology. The findings underscore the need for increased ophthalmologic monitoring in this patient population.

Large-Scale Cohort Analysis Reveals Elevated Uveitis Risk

The study, led by Dr. Yung-Yu Chu of Chi Mei Medical Center in Tainan City, Taiwan, analyzed data from 114,889 children with early-onset AD and an equal number of propensity score-matched controls without AD. The aim was to assess whether early-onset AD increases the risk for pediatric uveitis—a potentially sight-threatening inflammatory condition of the eye.

Key Findings:

       • The incidence of pediatric uveitis was higher in the AD group (0.08%) compared to controls (0.05%)

       • The hazard ratio (HR) for uveitis in children with AD was 1.92, indicating a nearly twofold increase in risk

       • Among patients not treated with dupilumab, the HR remained elevated at 1.77

       • In children without autoimmune conditions, the HR was 1.52

       • Severe AD was associated with a substantially higher risk of uveitis (0.40%) compared to nonsevere AD (0.08%), with an HR of 3.64

Implications for Ophthalmic Practice

“This cohort study of children with early-onset AD found an elevated risk of pediatric uveitis compared with matched controls, independent of autoimmune conditions or dupilumab use,” the authors noted.

These findings highlight the potential value of proactive ophthalmologic screening for pediatric patients with AD, particularly those with early-onset or severe forms of the condition. Uveitis can progress silently and may lead to complications such as cataracts, glaucoma, or vision loss if not diagnosed and treated early.

Clinical Considerations

Pediatric uveitis often presents diagnostic and management challenges due to its subclinical onset and potential for long-term ocular damage. The association with early-onset AD adds another risk factor for clinicians to consider when evaluating ocular health in children with dermatologic conditions.

Reference:

Yung-Yu Chu et al, Risk of Developing Pediatric Uveitis Among Patients With Early-Onset Atopic Dermatitis, JAMA Ophthalmology (2025). DOI: 10.1001/jamaophthalmol.2025.0366